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Related Concept Videos

Drugs for Treatment of Ulcerative Colitis in IBD01:29

Drugs for Treatment of Ulcerative Colitis in IBD

332
Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
332
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

349
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
349
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

313
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
313
Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

317
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
317
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

329
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
329
Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

659
Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
659

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Updated: Dec 3, 2025

Analyzing Beneficial Effects of Nutritional Supplements on Intestinal Epithelial Barrier Functions During Experimental Colitis
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Nonbiologic Immune Suppression in Ulcerative Colitis.

Valérie Heron1, Edward V Loftus2

  • 1Department of Gastroenterology, University of Montreal, Hopital Maisonneuve-Rosemont, 5415 Boulevard de l'Assomption, Montreal, Quebec H1I 2M4, Canada.

Gastroenterology Clinics of North America
|October 30, 2020
PubMed
Summary
This summary is machine-generated.

For ulcerative colitis, nonbiologic immunosuppressants like azathioprine are not recommended for induction. Thiopurines and tofacitinib show promise for maintenance and induction, respectively.

Keywords:
AzathioprineCyclosporineMercaptopurineMethotrexateTacrolimusTofacitinibUlcerative colitis

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Area of Science:

  • Gastroenterology and Immunology
  • Pharmacological Treatments for Inflammatory Bowel Disease

Background:

  • Ulcerative colitis (UC) management involves various immunosuppressive agents.
  • Current guidelines offer varying recommendations for nonbiologic immunosuppressants in UC induction and maintenance.
  • Understanding the efficacy of agents like thiopurines, methotrexate, and newer options is crucial for optimizing patient care.

Purpose of the Study:

  • To review the role of nonbiologic immunosuppressive agents in inducing and maintaining remission in ulcerative colitis.
  • To synthesize evidence from meta-analyses and North American guidelines regarding these agents.
  • To provide evidence-based recommendations for clinical practice in UC treatment.

Main Methods:

  • Systematic review of existing literature, including meta-analyses and clinical guidelines.
  • Analysis of data on azathioprine, mercaptopurine, methotrexate, tofacitinib, cyclosporine, and tacrolimus.
  • Evaluation of agent efficacy for both induction and maintenance phases of ulcerative colitis therapy.

Main Results:

  • Azathioprine, mercaptopurine, and methotrexate monotherapy are not recommended for UC induction.
  • Thiopurines are recommended in combination with infliximab for induction.
  • Tofacitinib demonstrates efficacy as an induction agent; cyclosporine and tacrolimus are also viable induction options.
  • Thiopurine monotherapy is suggested for maintenance in steroid-induced remission.
  • Tofacitinib is effective for maintenance in moderate to severe UC.
  • Methotrexate monotherapy is not recommended for maintenance.

Conclusions:

  • Nonbiologic immunosuppressants have specific roles in UC management, with varying utility in induction versus maintenance.
  • Combination therapy (thiopurines with infliximab) and newer agents like tofacitinib show significant promise.
  • Careful consideration of agent choice based on disease phase and prior treatment response is essential for effective ulcerative colitis management.